Aims On behalf of the IBTCM we completed a retrospective study of trends in the Higher Specialist Training (HST) Scheme in Cardiology since its inception in 1998 (relates to the Rep. of Ireland trainees only). Our intention was to examine the data for any notable trends in gender balance, completion rates, subspecialty training location, subspecialty, eventual geographical post location, and public/private mix.

Methods A database was compiled by the second author. This data was augmented by information gathered from online sources including published resumes, hospital departmental profile pages, PubMed author searches and professional profiles published on LinkedIn.

Results A total of 136 doctors have entered the Cardiology HST Scheme since 1998. 90 have qualified, 28 are currently in training, 3 are on a leave of absence, 12 are presently on fellowship/subspecialty training, and 3 have resigned from the scheme. The gender balance was found to be as follows male v female: Overall: 70%v30%. Qualified: 72%v28%. In Training: 57%v 43%. On average the scheme took 6.3 years to complete. On average 7.4 doctors are enrolled on the scheme each year (nadir of 4 in 2009, peak of 10 in 2002 and 2006). On average 5 doctors qualify from the scheme each year (nadir of 1 in 2000, 2 in 2004, peak of 10 in 2012). Private only posts – in the 5-year period of 2007 to 2011, 2 such posts were filled, from 2011–2016, 7 such posts were filled.

In geographical terms, after qualification, the most popular post location was Ireland (53.3%), followed by the USA (14%), then the UK (12%).

Conclusions The HST Scheme has a high rate of successful completion. In Ireland cardiology remains a male dominated specialty (27% female), though there is a trend seen in the current trainees towards greater gender equality. This is in marked contrast to the gender balance found in cardiology trainees across Europe(Female:43%Ireland,70%Europe) and in Irish HST trainees in general (55% female).

Interventional cardiology (46%) followed by imaging (24%) (encompassing Echocardiography, Cardiac CT and MRI) eclipse the other subspecialties, combined those specialties make up 70% of those qualified since 1998. A small but notable increase in those qualifying with EP subspecialisation was in seen in the last 10 years, however only 1 out of 6 of those qualifying found posts in Ireland. In geographical terms, a little over half of those enrolled on the scheme return to Ireland post qualification. North America remains a popular choice for subspecialty training. However, in more recent years there seems to be a trend towards increased subspecialty training in Europe. An increased popularity in private only posts has been noted in recent years. It is hoped that this work will in the future be expanded to include comparisons with data from the UK and the EU as a whole.